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The characteristic of nonmotor symptoms with different phenotypes and onsets in multiple system atrophy patients

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单位： [a]Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin 300070, China [b]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China [c]Department of Neurology, Cangzhou People’s Hospital, Cangzhou, Hebei 061000, China [d]Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin 300350, China [e]Tianjin Dementia Institute, Department of Neurology, Tianjin Huan hu Hospital, Tianjin 300350, China [f]Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou 450003, China [g]Department of Neurology, China-Japan Friendship Hospital, Beijing 100029, China [h]Department of Neurology, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, Hebei 050051, China [i]Department of Neurology, Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450007, China [j]Department of Neurology, Peking University First Hospital, Beijing 100034, China [k]Department of Neurology, Hebei Medical University First Affiliated Hospital, Shijiazhuang, Hebei 050030, China [l]Department of Neurology, Second Hospital of Tianjin Medical University, Tianjin 300211, China [m]Department of Neurology Ward 3, Kaifeng Central Hospital, Kaifeng, Henan 475001, China [n]Department of Neurology, Tianjin First Central Hospital, Tianjin 300190, China [o]Department of Neurology, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, Hebei 050011, China [p]Department of Neurology, Beijing Aerospace General Hospital, Beijing 100012, China [q]Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China [r]Department of Neurology, Second Affiliated Hospital of Hebei, Shi Jiazhuang, Hebei 050000, China [s]Department of Neurology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan 450052, China [t]Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huan hu Hospital, Tianjin300350, China

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关键词： Multiple system atrophy Nonmotor symptoms Gender Different phenotypes Autonomic and motor onsets Multicenter study

摘要：

The characteristic of nonmotor symptoms in patients with multiple system atrophy (MSA) has varied among previous studies. The objective was to investigatethe nonmotor characteristics in MSA patients with different phenotypes, sex and different onset patterns.We performed a retrospective review of 1492 MSA patients. All cases were evaluatedby neurologists and assessed with motormanifestations, nonmotor symptoms, auxiliary examinationand brain MRI scans.Multiple system atrophy-cerebellar ataxia (MSA-C) was the predominant phenotype in 998 patients. Average age of onset (56.8 ± 9.2 years) was earlier, the disease duration (2.4 ± 2.2 year) was shorter and brain MRI abnormalities (49.2 %) were more frequently in MSA-C (P < 0.001). Multiple system atrophy-parkinsonism (MSA-P) patients were more likely to have nonmotor symptoms. After adjusted significant parameters, urinary dysfunction (OR 1.441, 95 %CI = 1.067-1.946, P = 0.017), constipation (OR 1.482, 95 %CI = 1.113-1.973, P = 0.007), cognitive impairment (OR 1.509, 95 %CI = 1.074-2.121, P = 0.018) and drooling (OR 2.095, 95 %CI = 1.248-3.518, P = 0.005) were associated with the MSA-P phenotype. Males were more likely to have orthostatic hypotension, urinary dysfunction, sexual dysfunction, drooling and females in constipation and probable RBD. In different onset patterns, constipation (59.2 %) and probable RBD (28.4 %) were more frequently in autonomiconset pattern.MSA-C is the predominant phenotype in Chinese patients, while many nonmotor symptoms are more common in MSA-P phenotype. Patients with different sex and onset patterns have different nonmotor characteristics. The different clinical features identified could help the physician counseling of MSA patients more easily and more accurately.Copyright © 2022. Published by Elsevier Ltd.

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出版当年[2022]版：

大类 | 4 区医学

小类 | 4 区临床神经病学 4 区神经科学

最新[2025]版：

大类 | 4 区医学

小类 | 4 区临床神经病学 4 区神经科学

JCR分区：

出版当年[2021]版：

Q4 CLINICAL NEUROLOGY Q4 NEUROSCIENCES

最新[2023]版：

Q3 CLINICAL NEUROLOGY Q4 NEUROSCIENCES

影响因子： 最新[2023版] 1.9 最新五年平均[2021-2025] 1.9 出版当年[2021版] 2.116 出版当年五年平均[2017-2021] 2.236 出版前一年[2020版] 1.961 出版后一年[2022版] 2

第一作者：

第一作者单位： [a]Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin 300070, China [c]Department of Neurology, Cangzhou People’s Hospital, Cangzhou, Hebei 061000, China

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通讯作者：

通讯机构： [a]Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin 300070, China [b]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China [s]Department of Neurology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan 450052, China [t]Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huan hu Hospital, Tianjin300350, China [*1]Department of Neurology, Tianjin Huan hu Hospital, 6 Jizhao road, Jinnan District, Tianjin 300350, China. Department of Neurology, Beijing Tian tan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, 119 South Fourth Ring West Road, Beijing, 100070, China [*2]Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China

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The characteristic of nonmotor symptoms with different phenotypes and onsets in multiple system atrophy patients

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